HomeMy WebLinkAbout628 E Magnolia St - Permits/Reroof - 11/06/1986'---City _ o f—' Fiort Co11iy1S BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address -
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Name ; —
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Mail Address �' ; r 7.-t
Phone _4l-`�--1-•7�
Name
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Address.'
_
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License No.
Phone 45'f-q—
C
v
Lot
Block
Filing Number
Subdivision
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PUD
or
.
Parcel #
DESCRIPTION OF WORK
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Stock Options
Plan No.
_ ttrC_odes,(',.�}
Est. Total Cost
(including labor, material, profit)
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
- signed �—. _ dale -
— CL S OF WORK —
New Alters i Addition Demolish Move
❑ ❑ ❑ ❑
Plbg. MAK, Elec, Struct. Fire Prot.
❑ ❑ ❑ ❑ ❑
Occ, Gr. Type Const.
UserZone
Use of Building -T j
Floor Area (
'eight r,:: - It
H
No. Storiesfr ,g (
jot•Ar d
Frontage
`
Occ, load'r'
r.
hange from�r
Occ. C.-
ti.
Plat File No. "'.
No. D.U.
Garage area
Fin. Bsmt. area
Type heat
No. Fireplaces or stoves
— RELEASES — . Dates
Zoning
Engineering
Fire Department
Electric Department '
Water & Sewer
Plan Review
Special Conditions:
Valuation -FEES
Plan Check
Permit
' -.,1 /r .-
Parkland
-
City Sales Tax
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees; —, - —
Off -Street Parking
(No. Cars)
Interior Lot
❑
Corner Lot
❑
Reversed Corner Lot
❑
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Street
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ZBA Case #
Date
SBA Case #
Date
Building Insp. Approval
T
by date
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P
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C---P It No. r�
Date
Distribution. Original - Applcant, Blue -Office; Canary - Sales Tax: Pink - Applicant. Tag - Bldg, Insp.
1